Purpose of reviewInfection and sepsis remain major challenges in the critically ill. How nutritional therapy can effect real clinical outcomes is not easily apparent from the clinical data. Despite reducing infectious incidence, many studies show little difference in meaningful clinical outcomes.Recent findingsConfusion over the role that nutrition and nutrition practice in intensive care plays in preventing infection, and later how nutrition aids recovery from sepsis perhaps explains many of the misconceptions and difficulties with the evidence.SummaryEncouraging new evidence will help our decision making and shows that outcome can be improved by performing relatively simple therapies well.